Why Work is Not My Purpose

Right now I’m rotating on geriatric psychiatry (in the words of my orthopedic surgeon friend, “my two least favorite words”). While I don’t share his sentiment about psychiatry, I agree that the geriatric part is a drag. There’s nothing like a full roster of patients with advanced dementia and behavioral agitation to make you want to add “self-euthanization” to your advanced directive. I have to say, though, thus far intern year has been relatively benign, and this is the first time I’ve gone from passively questioning what’s so great about this medicine thing to seriously looking for a way out.

I love psychiatry, but sometimes I feel I don’t share the same passion for work as a lot of my colleagues. They eagerly stay late, spending the extra time to spruce up their progress notes, or make phone calls to check in with family members, or read the latest articles on Haldol vs. Seroquel for delirium, or whatever it may be. In comparison, my desire for thoroughness is woefully inadequate. I’m more of a “just get the job done” type of person. I never do anything work-related outside of the time I spend in the hospital, unless I have to. Similarly, it seems like a lot of future-doctors like the security and stability that medicine offers, and look forward to having a day job. To me, the idea of giving hours of my time in exchange for a stable amount of money feels like a trap. I don’t want to be stuck clocking in and out when someone else tells me to, to see the types of patients I don’t want to see, or overall to have someone besides me manage my time. I greatly appreciate the opportunity I have to do work that is will positively impact the lives of others. That’s a gift a lot of people don’t have. It’s just that I live my life in the hours I’m not at work, when I have control over how I spend my time and direct my energies. I live for the moments when no one is telling me what to do or where to be. On the bad days of residency, which have been happening more frequently lately, I get discouraged about how my days are not my own right now, and won’t be for quite a number of years, until I finish residency and pay off my loans.

Work is not my purpose. If I didn’t need to have a day job for financial reasons, I wouldn’t. Don’t get me wrong- I wouldn’t spent my days playing World of Warcraft and eating frozen pizzas. There are so many interests I have and skills I want to learn that I get excited just thinking about it. I have arguments with family and friends who don’t seem to understand the sentiment. “Oh,” they insist, “if you didn’t have a job, you’d get bored after a couple of months.” Really? I think not. It’s going to take more than a couple of months for me to become a world class ukulele player, and i don’t know how long it takes to learn Mandarin Chinese, but I hear it’s hard. Here’s a small sampling of the things on my “life to-do list” to give you an idea of what I mean (feel free to laugh at my over ambition bordering on delusion):

• Become a computer programmer/hacker (movies make it look so cool!)
• Practice playing: ukulele, guitar, voice, cello, standing bass
• Start a business
• Write and publish a book
• Learn how to trade stocks
• Stay active- surfing, snowboarding, yoga, running. Go heliskiing someday.
• Become a gourmet cook
• Learn French
• Create/direct movies or short films
• Buy land in Nicaragua and move there.

I think anyone who needs a job to fill their time is suffering from a lack of imagination. The more you work according to someone else’s demands, the more you lose touch with with how you’d really like to spend your time, and the less you’re able to imagine all the other things that are possible. I heard of a 2nd year anesthesia resident lamenting that now that she was done with intern year and had more time, she wasn’t sure how to use it and ending up staying late at the hospital anyway. That’s sad.

Jobs are fine if you love what you do, exactly as you’re doing it, but the key isn’t that you have a job, but that you are productive and fulfilled by how you spend your time. Forward movement- learning, creating, growing- is what creates purpose, whether it is in your work, your hobbies, or your relationships. You don’t need a day job to feel that your life is meaningful.

Anyway, I’ve digressed from original thought I had when I first sat down to write this post, which is that intern year kind of blows right now, and is definitely not how I’d choose to spend my time if I had any other great options. I feel beat down, overwhelmed by the magnitude of the task in front of me, and discouraged by my own exhaustion. But at the same time, would I really want things to be easy all the time? Everything is relative, and when work and life are easy and pleasant for too long, they start to feel boring and monotonous. You need the bad moments as a counterpoint so you appreciate the good. Anyone who has experienced that euphoria that comes from leaving the hospital post-call knows what I’m talking about. Second of all, there is no growth when things are easy. It is when I’m in pain that I feel motivated to understand how I create my own suffering, and to look internally for change as opposed to expecting the world to change for me. It’s empowering to realize you can change how you react to the world as opposed to struggling to make the world conform to how you think it should be. Trust me- the former is a lot easier.

That’s all for now. I’ve got three more weeks of geriatric psychiatry, and then I have two glorious weeks of vacation.